The state of our health care system

Trump didn’t have much to say about health policy during the State of the Union last night. But we’re definitely at a health care crossroads right now. So I asked a handful of the smartest policy experts for their assessments.

What they’re saying: The state of the health care system is... all over the place, depending on who you ask. But most experts agree that it's in a time of upheaval and uncertainty.

• “Mixed and murky … The ACA marketplace gets all the attention, and while enrollment has been stronger than expected and insurers are now profitable, the future is uncertain … Looking at the bigger picture, we in the U.S. spend far more on health care than any other wealthy country, and what we get for it is worse outcomes and shorter life expectancy.” — Larry Levitt, Kaiser Family Foundation
• “Exciting … There is a tremendous space for innovation and experimentation … The challenge now is for the states to find ways to craft programs that fit local circumstances and values.” — David Anderson, Duke University
• “Complicated, and things will get more complex before they get easier ... It will be a time period of trade-offs, where attempts to gain savings will require that some people won’t get access to low-value care that they desire, while others will hopefully get the care that they need.” — Craig Garthwaite, Northwestern University
• “Better than we expected a year ago, but still greatly uncertain … The irony of the past year is President Trump and Republicans have ratified the public consensus around the ACA, and maybe something more radical.” — Harold Pollack, University of Chicago

The bottom line: We're in a period of intense change, both politically and practically.